Innovation and Failure in Developing New Psychiatric Treatments

With nearly 2 decades of leadership, Dennis S. Charney, MD has championed a culture of innovation, resilience, and bold scientific inquiry. In an interview with Psychiatric Times, he shared the importance of research that directly impacts patient lives.

"If at the end of your career, all you've done is publish papers in top journals and get grants, it's not enough," said Charney about advice he gives to his faculty and mentees alike. "You really want your research to make a difference in the lives of patients."

This mindset led Charney and his team to groundbreaking work on ketamine as a treatment for depression. Their research was met with initial setbacks, but Charney viewed failure as a necessary part of scientific progress. "If you're not failing, you’re not trying hard enough," he asserted. "You learn from your failures, and that was our experience in studying ketamine." After the initial findings were published in the discovery of ketamine as an antidepressant in 2000, it took a second, larger study conducted with the National Institute of Mental Health for the field of psychiatry to take notice.

Despite ketamine’s success, Charney expressed concerns about the rapid proliferation of off-label ketamine clinics. "We had concerns about these clinics emerging because a lot of the necessary studies weren’t done to show how beneficial ketamine was or what the side effect profile was," he said. While he supports treatments approved by the US Food and Drug Administration like esketamine (Spravato), he acknowledgd his own financial interest in its success, having his name on the patent.

Beyond ketamine, Charney said he is optimistic about emerging treatments, including psychedelics, although he noted that they still need well controlled studies to prove the right dose and the proper environment to administer the treatment. He also expressed interest in immunologic therapies, and neuromodulation techniques like transcranial magnetic stimulation and deep brain stimulation. "The more we learn about the circuitry of depression with brain imaging studies, the greater the potential to develop many more treatments," he said.

Charney’s message to researchers is clear: take risks, embrace failure, and focus on making a tangible difference in patient care. "To do that, you have to be bold."

This is part 5 of a multipart video series. You can watch part 1 here, part 2 here, part 3 here, and part 4 here.

Dr Charney is the dean of the Icahn School of Medicine at Mount Sinai. He is the author of Neurobiology of Mental Illness, The Physician’s Guide to Depression and Bipolar Disorders, and Molecular Biology for the Clinician. He is a professor of psychiatry, neuroscience, and pharmacology and systems therapeutics at Icahn School of Medicine at Mount Sinai.